Category Archives: Politics

Political observations.

What Does The CBO Say?

Last week the Congressional Budget Office released “The Budget and Economic Outlook: 2014-2024.” Conservatives and the right-wing media got an instant woody over Appendix C – Labor Market Effects of the Affordable Care Act: Updated Estimates. The ACA would kill 2.5 million jobs, take away the incentive to work and put millions more on the dole.

The White House, predictably, embraced the report as a victory of sorts for the beleaguered American wage slaves who have been worried they will die chained to their desks.  Meanwhile, Politico accuses both sides of “cherry-picking” the data in the report.

(C) Can Stock Photo

(C) Can Stock Photo

So what to make of all this?  Here’s my take.

First, CBO’s projections are educated guesses about the future based on current data and realities that are likely to change, requiring further analysis and adjustments.  Indeed, the CBO admitted:

“…estimate(s) of the ACA’s impact on labor markets (are) subject to substantial uncertainty, which arises in part because many of the ACA’s provisions have never been implemented on such a broad scale and in part because available estimates of many key responses vary considerably. CBO seeks to provide estimates that lie in the middle of the distribution of potential outcomes, but the actual effects could differ notably from those estimates…”

The claim that there will be 2.5 million fewer jobs by 2024 can be blamed on conservative animosity towards the ACA, aided by the CBO’s authors’ poor choice of words.  The report forecast workers voluntarily reducing their labor by 2.5 million full-time equivalent hours. That will likely happen mostly among low wage workers, amounting to 1.5 percent to 2.0 percent of total hours worked.

“…The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses’ demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what would have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week)…”

Those workers are NOT quitting altogether to go on the dole. Some may go to part-time jobs; others may retire early. There are 10,000 Baby Boomers retiring every day through 2031; their exit from the workplace could potentially create job openings for younger, qualified currently unemployed workers.

However, any potential job changes come with trade-offs.

Full-time employees whose income is more than 400% of the Federal Poverty Level (FPL) or whose employers offer health insurance are not eligible for subsidies for health insurance purchased through the exchanges. So they will either continue to work full-time, switch to a different full-time job, or go to part-time jobs and purchase their own insurance, especially if the net result is working fewer hours while maintaining their desired standard of living.

Employees whose income is less than 400% FLP or whose employer does not offer insurance can obtain insurance through the exchange, and they are eligible for tax credits and subsidies, which decrease as income increases. They might work less to avoid crossing the FLP threshold which means losing their subsidies and credits while effectively hiking their taxes. But then again, they might decide the extra income is worth the tax bite

People living in states that agreed to expand Medicaid are now eligible for Medicaid benefits if their income is less than 138% FLP. If they earn more, they’ll be eligible for insurance subsidies, ensuring they won’t lose coverage. People living in states that did not expand Medicaid, however, can only get insurance subsidies, not Medicaid.

I think the real issue is: conservatives and their corporate overlords hate losing the leverage that health insurance once gave them over workers.  How many people have endured “job lock,” staying in a thankless job, working more hours for less pay, working for condescending employers who’ve made it abundantly clear employees are unimportant, easily replaced, but a necessary evil?  Have you ever been told, “Bend over and like it because there are ten other people out there waiting for your job?”

Employers might be a little more considerate now that health insurance isn’t always tied to the job. I’m not holding my breath.

Coca-Cola vs the Wretched Refuse

In 1971, Coca-Cola produced the multicultural (and overly saccharine) “I’d Like To Teach The World To Sing” commercial and no one said anything.Coke hilltop7

In 1979, Coca-Cola jerked our heartstrings with the inter-racial Mean Joe Green ad, and in 2009 used Troy Polamalu in the parody hawking Coke Zero.  It wasn’t a big deal.coke-mean-joe

In 1990, Coke resurrected the 1971 Hilltop ad, this time with the original singers and their families.  Some of us groaned after hearing “that song” again, but no one complained.

In 2014, Coke aired a beautiful multi-lingual version of America the Beautiful.  And the right wing knuckle-draggers went ape shit, saying that singing “our national anthem” in anything but English was a travesty.Coke 2014

What the hell is the matter with you people? First, our national anthem is The Star-Spangled Banner and the tune is To Anacreon in Heaven ,an English drinking song.  Second, Katharine Lee Bates, who wrote America the Beautiful after hiking to the top of Pikes Peak, also wrote a collections of sonnets for her lover, Katharine Coman.

English may be the predominant language in the U.S., but it is not the official language. Unless your ancestors came from England, they spoke French, German, Dutch, Russian, Yiddish, Spanish, Portuguese, Norwegian, Swedish, Finnish, Chinese, Japanese, Gaelic, and whatever passes for English in Scotland. And the native tongue was anything BUT English if your ancestors were here before Columbus.

And when did we become the United States of Exclusively White People?  Which white people? The Irish were once scorned, partly for being Roman Catholic.  In 1889, the Bennett Law tried to make English the official language in Wisconsin, pissing off the Germans and Norwegians. So we’ve all been shunned at one time or another.

I live in the Chicago suburbs and we love our multicultural heritage. There are Asian, African-American, Hispanic, South Asian and Middle Eastern families within three blocks of my house. The son of the old Pakistani man drives a big-ass Dodge Ram pickup with a Chicago Bears sticker in the rear window.

Chicago has arguably the largest Polish population in the country and in a month we’ll be celebrating Fat Tuesday with P?czki (pronounced POHNCH-kee), a jelly doughnut on steroids. paczki The city has ethnic festivals all summer long: Italian, Greek, Chinese, Thai, German, Hispanic, Irish, African, and Korean. There are African-American, gay, St. Patrick’s Day, Southside Irish, Northwest Side Irish, Chinese, Greek, Mexican, Polish and Puerto Rican parades every year.

No one is “shoving multiculturalism down our throats.”  It’s been here as long as we have.  No one says you have to participate, but you do have to tolerate it just as they tolerate you. I realize some of you resent having to sharing the pie, but that’s the price you pay for living in the melting pot. The Pledge of Allegiance reads, “…liberty and justice for all,” not “for some privileged people.” If you don’t believe me, maybe John Winger can convince you

“We’re all very different people. We’re not Watusi. We’re not Spartans. We’re Americans, with a capital ‘A’, huh? You know what that means? Do ya? That means that our forefathers were kicked out of every decent country in the world. We are the wretched refuse. We’re the underdog. We’re mutts!”

Oh, and for those of you boycotting Coke, Pepsico backs gay rights and its CEO and Chair is Indra K. Nooyi, an Indian-American woman.  Just thought you should know.

A Little Perspective, Please (Part 2)

Since it’s Thanksgiving weekend, I’ll be brief.

4.2.7

34 “Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. 35 For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36 I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’

37 “Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? 38 When did we see you a stranger and invite you in, or needing clothes and clothe you? 39 When did we see you sick or in prison and go to visit you?’

40 “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’

Matthew 25:34-40

Affordable Care Act Timeline: 2012-2014

2012 

  • Established Value-Based Purchasing program (VBP) in Traditional Medicare, offering financial incentives to hospitals to improve the quality of care.
  • Provided incentives for physicians to join together to form “Accountable Care Organizations” to better coordinate patient care and improve the quality, help prevent disease and illness and reduce unnecessary hospital admissions. ACOs will get a financial reward for providing high-quality care at lower cost.
  • Instituted changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care.
  • Required any ongoing or new federal health program to collect and report racial, ethnic and language data to help identify and reduce disparities.

2013 

  • Provided new funding to state Medicaid programs that choose to cover preventive services for patients at little or no cost.
  • Established a national pilot program to encourage hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care.
  • Required states to pay primary care physicians no less than 100% of Medicare payment rates in 2013 and 2014 for primary care services, with the feds picking up the tab.
  • The Health Insurance Marketplace for individuals and small businesses opened October 1, 2013.

January 1, 2014 

  • Prohibits insurance companies from refusing to sell coverage or renew policies because of an individual’s pre-existing conditions
  • Eliminates the ability of insurance companies to charge higher rates due to gender or health status in the individual and small group markets.
  • Phased out annual limits on insurance coverage starting September 23, 2011 and eliminates them entirely January 1, 2014
  • Prohibits insurers from dropping or limiting coverage of individuals participating in clinical trials.
  • Provides tax credits for insurance for people with income between 100% and 400% of the poverty line—about $43,000 or less in 2010—who are not eligible for other affordable coverage.
  • Opens the Health Insurance Marketplace to people whose employers don’t provide benefits.
  • Increases the Small Business Tax Credit up to 50% for “qualified” small businesses and up to 35% for small non-profit organizations.
  • Allows anyone earning less than 133% of the poverty level (about $14,000 for an individual and $29,000 for a family of four) to enroll in Medicaid, with 100% federal funding for three years and then no less than 90% federal funding for subsequent years.
  • The individual mandate becomes effective January 1, 2014.  Everyone who can must purchase insurance or pay a fine.

 

“New Rule: the Republicans have to stop saying that if the Obamacare website doesn’t work that must mean Obamacare itself doesn’t work.  That is like saying the ice cream’s no good because you can’t find a spoon.  And the ice cream is good!  That’s why you can’t find any spoons; they’re all in the dishwasher.”

Bill Maher – November 15, 2013

obamacare_Republican sledgehammer

Conservatives and the media are gleefully focusing on the Health Insurance Marketplace’s rocky rollout while ignoring the rest of the Affordable Care Act’s provisions.  They’re also hypocrites for condemning the $70 million “wasted” on the Marketplace’s computer system, which is only 3% of the $24 BILLION Congressional Republicans wasted by shutting down the government for 16 days.

I edited the Health and Human Services’ overview, Key Features of the Affordable Care Act by Year , for easier reading.  Here’s what we will give up if “Obamacare” is repealed.

2010

  • Insurers can’t deny coverage for children under 19 because of pre-existing conditions
  • Insurers can’t rescind coverage because of a “technical mistake” on an application.
  • Lifetime coverage limits  have been eliminated.
  • Annual coverage limits have been restricted.
  • Provided for an external review mechanism for denied claims.
  • Provided a one-time, tax-free $250 rebate check to seniors in the Medicare D “donut hole.”
  • New health plans have to provide preventive care services without charging a deductible, co-pay or coinsurance,
  • Gave a tax credit for up to 35% of the premium costs for small employers and up to 25% for small non-profits.
  • Allocated more money and staff to combat fraud and waste in Medicare, Medicaid and CHIP.
  • Awarded grants for the state insurance navigators program (October 2010).
  • People with pre-existing conditions who were uninsured for >6 months got access to state or DHHS insurance coverage.
  • Allowed adult children to stay on their parents’ insurance until they turned 26.
  • Created a $5 billion dollar program to continue employee coverage for early retirees.
  • Created incentives to increase the number of primary care physicians, nurses and physician assistants.
  • Allocated $250 million in grants to states plans to require insurance companies in the individual and small business markets to justify rate hikes of >10%.
  • Banned companies with excessive or unjustified rate hikes from participating in the new exchanges in 2014.
  • Provided federal funds for states expanding Medicaid coverage.
  • Increased payments to rural health care providers.
  • Allocated funds to support construction and expansion of community health centers.

2011 

  • Provided 50% discount on brand-name drugs for seniors reaching the “donut hole”
  • Provides additional savings on brand-name and generic drugs through 2020 when the “donut hole” will close.
  • Provided for certain free preventive services for seniors on Medicare.
  • Created Center for Medicare and Medicaid Innovation to test new care delivery models, improve care quality and slow the rate of growth of health care costs.
  • Established the Community Care Transitions Program to coordinate care for high-risk Medicare patients after hospital discharge.
  • Established the Independent Payment Advisory Board to recommend ways to target waste, reduce costs, improve health outcomes, expand care access and extend the life of the Medicare Trust Fund.
  • Allowed states to offer home and community based services to disabled individuals through Medicaid rather than institutional care in nursing homes through the Community First Choice Option.
  • Required insurers for large employers to spend at least 85% and individual and small employer plans to spend at least 80% of all premium dollars on health care services and health care quality improvement and provide rebates if profits or administrative costs are too high.
  • Gradually eliminates overpayment to Medicare Advantage plan insurers; will give bonuses to Medicaid Advantage plans providing “high-quality care.”

Part 2 will look at 2012-present.

What do my taxes buy me?

Inevitably I find myself arguing with someone who thinks taxes are (a) illegal, (b) theft and (c) a liberal scheme allowing me to give their money to someone else.  For some reason, they don’t think liberals pay taxes, or they think the Treasury Department singles their tax dollars out for welfare recipients just to piss them off. I don’t know of any civilized country that does not tax its citizens and when I suggest finding one, the silence is deafening.

Uncle-Sam-TaxesNow, I actually LIKE paying taxes because, among other things, it means I’m gainfully employed.  I see federal income taxes as the rent I pay to live in a country that allows people to become filthy rich if they so desire.  In other words, I feel an obligation to support my country.

So, when someone asked me, “What do your taxes buy for you?” I came up with this list.

  • Military protection
  • Benefits for those who protected me, some of whom lost limbs, others who lost their minds.
  • People who talk to other countries to avoid wars
  • Cops
  • Firefighters
  • Good roads
  • Libraries
  • Museums
  • National parks to enjoy
  • My primary and secondary education
  • My medical school education, making me a productive member of society
  • My kids’ and other people’s educations so I don’t live in a society of morons
  • Money for research for things that make my life better
  • The opportunity for poor people to get an education without going bankrupt
  • People inspecting my food
  • People making sure my drugs are safe
  • People making sure my flight doesn’t collide with someone else’s
  • Aviation security
  • Health care in my old age
  • Cheaper drugs in my old age
  • Some income security in my old age
  • Some income security if I lose my job
  • Food assistance so other people less fortunate than me don’t starve because I’m not heartless
  • Help if a tornado or hurricane destroys my house/community
  • Watchdogs to chase polluters
  • Someone to cheaply deliver letters
  • Border patrol
  • Customs inspectors
  • A civilized existence

I remain grateful and unapologetic.